To, Annexure

The Assistant General Manager

STATE BANK OF INDIA
R.A.C.P.C. South Extn.
New Delhi

STANDING INSTRUCTION (DYNAMIC) TO DEBIT THE ACCOUNT

Date:....................... .

I/We hereby authorize State Bank of India to Debit my SB/CA/CC/SB-NRE/SB-NRO/Other Bank Ale No.
With Branch _
IFSC MICR
for an amount of Rs. Rupees
With Frequency Monthly/ Qtly / H-Yearly /Yearly/ As and when presented Up to a Maximum debit Mandate
of Maximum Rs. Maximum Rupees
For Reference 1 Loan Account No. Phone
E-mail for Period From _
To _

Iagree to pay applicable processing charges for accepting the debit mandate and authorize the Bank to debit
my account to recover the processing charges.

DECLARATION
i) IM/e authorize the Bank to debit my account based on the Standing Instruction (dynamic)
ii) IM/e hereby declare that Standing Instruction (dynamic) shall not be revoked by me/us sa long as I/Vl/e
remain in debited to the State Bank of India under the above Loan accounts.
iii) I/We undertake to maintain sufficient balance in my / our Bank account, to enable the Bank to process
the Standing Instruction on due dates.
iv) The terms of This declaration has been carefully read, understood and are voluntarily signed by me/ us.
v) In case of dishonor of the Standing Instruction, Bank shall be entitled to recover applicable charges and
take appropriate legal action as per the provision of Payment & Settlement System Act, 2007 or any
other law for the time being in force.

Signature Primary Account Holder Signature of Account Holder Signature of Account Holder

1. Name as in Bank Records 2. Name as in Bank Records 3. Name as in Bank Records

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